Provider Demographics
NPI:1801457387
Name:SUN TRAD CHIN ACU MN LLC
Entity type:Organization
Organization Name:SUN TRAD CHIN ACU MN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:XIAOYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, TCMD, LAC
Authorized Official - Phone:715-497-4817
Mailing Address - Street 1:COMPASS CENTER FOR HEALING
Mailing Address - Street 2:116 CHESTNUT ST. E.
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082
Mailing Address - Country:US
Mailing Address - Phone:715-497-4817
Mailing Address - Fax:715-629-2108
Practice Address - Street 1:COMPASS CENTER FOR HEALING
Practice Address - Street 2:116 CHESTNUT ST. E.
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082
Practice Address - Country:US
Practice Address - Phone:715-497-4817
Practice Address - Fax:715-629-2108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty